Kozol tells
a multilayered story about himself and his father, a distinguished physician
who becomes increasingly demented by Alzheimer’s disease, starting at age 88. A neurologist, Dr. Harry Kozol is able to diagnose with great specificity his own disease.

Son Kozol describes his father’s initial
symptoms and the slow decline, a direction that is sadly and fatefully, clear. The
son goes on walks with him, describes their conversations, arranges for paid
companions, and puzzles about what must be “a life beneath the life” of his
progressively inarticulate father.

Over the 14
years of this illness, there are some medical mishaps—including problems in
continuity of care—depletion of the family’s money, and Jonathan’s hesitation
to use a DNR (Do Not Resuscitate) order for his father or for his aging mother.
He writes of his doubts, uncertainties, and mixed emotions. When his father is
actively dying, Kozol dawdles elsewhere with lists and papers “obsessively.” He
understands this, in retrospect, as denial. Nevertheless he arrives at the
hospital and places his ear on his father’s chest, hearing breaths come slower
and slower until death. Dr. Kozol dies in 2008 at the age of 102.

Alternating
with this story are long passages about Dr. Kozol’s professional life,
including his work with Eugene O’Neill and family, also Patty Hearst and Albert
DeSalvo (“The Boston Strangler”). For the latter two, he is an expert witness
in court cases. These passages illustrate his many skills, tenacity, and
ideals.A 25-page Epilogue
written a half a dozen years later casts a different light on the father-son
relationship. While the bulk of the book shows a loving, respectful
relationship, the Epilogue describes tensions and disagreements between the two
from Jonathan’s childhood to later years. The father criticizes what he perceives as failures, lack of ambition, poor
choices, and the like. Kozol describes his own illustrious career, often in
directions his father disapproves. In later years, however, Kozol accepts some
of his father’s advice and understands their status more as equals. In another
seven years, however, Dr. Kozol’s mind starts its difficult path, and the son becomes
the caregiver to the father.

Many are familiar with these stories from the author's practice as a midwife among the urban poor in London's East End in the 1950s. Each piece stands alone as a story about a particular case. Many of them are rich with the drama of emergency interventions, birth in complicated families (most of them poor), home births in squalid conditions, and the efforts of midwives to improve public health services, sanitation, and pre- and post-natal care with limited resources in a city decimated by wartime bombings. As a gallery of the different types of women in the Anglican religious order that housed the midwives and administered their services, and the different types of women who lived, survived, and even thrived in the most depressing part of London, the book provides a fascinating angle on social and medical history and women's studies.

After
eleven minutes underwater at near-freezing temperature, Delaney Maxwell, who
appeared dead upon rescue, is revived.
Unlikely as her survival seems, the return of apparently normal brain
function seems even more unlikely, yet after a few days she is allowed to go
home with medications and resume a near-normal life. But after-effects of her trauma linger, the
most dramatic of which is that she develops a sixth sense about impending
death. She hides this recurrent
sensation from her parents, and from her best friend, Decker, who rescued her,
but finds that she shares the experience with a hospital aide who, like her,
suffered a coma after a car accident that killed his family members. Like her, he senses death in others. Gradually
Delaney realizes that “normal” isn’t a place she’s likely to return to, and
that Troy, the aide whose life has been a kind of “hell” since his own trauma,
is even further from normal than she.
Troy seems to feel that it is his mission to help hasten death for those
who are dying, to prevent prolonged suffering.
The story follows her efforts to stop him, and to communicate with close
friends, especially Decker, in spite of the
secret she carries about her own altered awareness. When her
efforts to save a friend who is dying of a seizure fail, Delaney faces another
moment of crisis, compounded by Troy’s own suicidal desire to end his own
suffering and hers with it. In the midst
of these new traumas a clarity she has lost about what it means to choose life
returns to her, and with it the possibility of a loving openness with parents and
friends about the mysteries of her own brain and heart.

Two individuals share a struggle that is
grueling, depressing, and whose outcome is probably preordained. The Mother
(divorced, constantly tired, and fearful of sickness) is "not a good
choice for the parent of a chronic invalid" (p. 168). The Son (smallish,
clever, and born with some kind of tumor) has previously had an organ
transplant (most likely kidney).

Their trek through the realm of sickness unfurls in seven scenes - all hospital
wards and finally Hospice. First, the Son is an adolescent in a pediatric ward
where the Machine (presumably renal dialysis) prevents his death. There he
spots a baby that he dubs a "Not-Dead." She has multiple birth
defects due to a chromosomal abnormality and is kept alive by technology. He
intuits that while not dead, the baby is not "properly alive" either.
He muses about his own status. His mother is always bedside, propping up his
spirits.

Next he is in the ICU and then transferred to a medical floor. He receives a
blood transfusion after disconnecting the Machine in a likely suicide attempt.
Sometime later, he is back in the pediatric ward after receiving an organ
transplant. The Son gets admitted to the Cardio-Respiratory unit for a severe infection.
In and out of hospitals, he enrolls in college but quits. After getting married,
he joins a commune of survivors of medical illnesses known as "The
Saved." This collective lives on a farm and members avoid any contact with family.

The Son's health further deteriorates. He is hospitalized in terminal
condition. By this time, he has his own child, a 14-month-old boy named
Jaybird. In the oncology ward, doctors diagnose three tumors in the Son's brain
but he refuses any treatment (surgery, radiation, or chemotherapy). He is moved
to Hospice. His absent Father comes to visit and comfort him. When the Son
dies, it is the Mother who is alone with him. The Son's wife, Father, Jaybird,
and members of The Saved commune are all asleep in the Day Room. Only after the
Son dies are the names of the Mother and the Son revealed: Julia and Jonathon.

A mother (termed Mother in the story) discovers a blood clot in her young son's diaper and wonders "so what is this thing, startling against the white diaper, like a tiny mouse heart packed in snow?" This discovery leads to a diagnosis of Wilms' tumor--a childhood malignancy of the kidney, and surgery to remove the diseased kidney.The parents are thrust into a new world--the world of pediatric oncology ("peed onk") and meet the Surgeon, the Oncologist, and the other anxious parents waiting in the Tiny Tim Lounge of the pediatric ward. Everyone is named by their relationship to the Mother or by their profession--Baby, Husband, Anesthesiologist.The reader is privy to the inner thoughts of the Mother--her anger, denial, protective instincts and dark ironic vision. The Mother is also a writer and advised to take notes of this odyssey in case they need money to pay the medical costs. She feels alien to the culture of the pediatric ward--only her artsy friends understand her hell. Notes one (Green Hair) "Everyone's so friendly here. Is there someone in this place who isn't doing all this airy, scripted optimism--or are people like that the only people here?"When the Mother is given the option of no post-operative chemotherapy for Baby, the Mother grabs the chance to leave the hospital, clutching Baby, and says "I never want to see any of these people again." The piece ends on the rhetorical and ironic question--where's the money for these notes, for the story?

A pot of boiling water falls off the stove. A diaper-clad toddler screams. His mother cries hysterically. The little boy is standing barefoot in a puddle of steaming water on the kitchen floor. The father who was busy hanging a door rushes into the room and quickly assesses the situation. He places the child in the kitchen sink and runs cold water over the boy.The child's skin is scalded. The father swaddles him in a wet towel but the toddler shrieks as if he is still being burned. Suddenly both parents realize they haven't checked the diaper. It burns their hands when they take it off. The diaper is filled with hot water that has collected inside it. The parents wrap their son in gauze and handtowels. They take him to the emergency room where "the child had learned to leave himself and watch the whole rest unfold from a point overhead." (p. 116)

When nine-year-old Rob Cole, child of poor 11th-century
English farmers, loses his mother, he is consigned to the care of a
barber-surgeon who takes him around the countryside, teaching him to juggle,
sell potions of questionable value, and assist him in basic medical care that
ranges from good practical first-aid to useless ritual. When, eight years later, his mentor dies, Rob
takes the wagon, horse, and trappings and embarks on a life-changing journey
across Europe to learn real medicine from Avicenna in Persia. Through a Jewish physician practicing in
England, he has learned that Avicenna’s school is the only place to learn real
medicine and develop the gift he has come to recognize in himself. In addition to skill, he discovers in
encounters with patients that he has sharp and accurate intuitions about their
conditions, but little learning to enable him to heal them. The journey with a caravan of Jewish
merchants involves many trials, including arduous efforts to learn Persian and
pass himself off as a Jew, since Christians are treated with hostility in the
Muslim lands he is about to enter.
Refused at first at Avicenna’s school, he finally receives help from the
Shah and becomes a star student. His
medical education culminates in travel as far as India, and illegal ventures
into the body as he dissects the dead under cover of darkness. Ultimately he marries the daughter of a
Scottish merchant he had met but parted with in his outgoing journey, and,
fleeing the dangers of war, returns with her and their two sons to the British
Isles, where he sets up practice in Scotland.

The author, an experienced surgeon, believes that we will be less frightened by the prospect of death if we understand it as a normal biologic process. He points out that 80 percent of deaths in this country now occur in hospitals and are therefore "sanitized," hidden from view, and from public comprehension. He describes the death process for six major killers: heart disease, stroke, AIDS, cancer, accidents/suicide, and Alzheimer's disease.But the power of the book is in its intensely personal depiction of these events and in the lessons which Nuland draws from his experiences. The message is twofold: very few will "die with dignity" so that (1) it behooves us to lead a productive LIFE of dignity, (2) physicians, patients, and families should behave appropriately to allow nature to take its course instead of treating death as the enemy to be staved off at any cost. Only then will it be possible for us to die in the "best" possible way--in relative comfort, in the company of those we love/who love us.

This poem describes how, during the anatomy lesson, the medical student feels curiosity about the wonders of the human body. He is torn between his desire for knowledge and the horror he feels in cutting up a dead body: "the violence of abomination." This marks a transitional point in the student’s medical career path.

Since Joy Davidman is known to most readers as the woman
C.S. Lewis married late in life and lost to cancer four years after that
marriage, it is likely that many readers will pick up Joy Davidman’s letters
out of fondness for her husband’s Narnia stories or popular theology. They will quickly find that the letters
chronicle a life of considerable interest in itself. Davidman was an award-winning writer herself,
a secular Jew and atheist who turned hopefully to communism and then
wholeheartedly to Christianity in her later years, though remaining
skeptical—and acerbic—about church people.
The fact that she remained friends with her first husband after their difficult
marriage broke up resulted in many of the letters in the collection, which
include material Lewis fans will be glad to see, though it offers little
intimate information about their lives except that they were devoted to one
another through her painful final years with breast cancer. Her account of that last illness is often
matter-of-fact; she writes as though it is one of the less interesting parts of
her life, which was full of intellectual pursuits, including editing some of
Lewis’s later works, and of practical concerns that included caring for her two
boys with whom she emigrated to England from New York.